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Invasive aspergillosis in leukemic children
T Shitara1, S Yugami, M Sotomatu
1Department of Pediatrics, Gunma University School of Medicine, Japan.
Pediatric Hematology and Oncology
|April 1, 1993
Summary
Invasive aspergillosis can affect extremities, causing necrosis. Combining urokinase with antifungal drugs may treat severe cases, particularly in immunocompromised patients.
Area of Science:
- Medicine
- Infectious Diseases
- Hematology
Background:
- Invasive aspergillosis is a serious fungal infection, often occurring in immunocompromised individuals.
- Extremity involvement in invasive aspergillosis is rare but can lead to severe complications.
Observation:
- Two cases of invasive aspergillosis in pediatric and young adult patients with hematologic malignancies are presented.
- Case 1: A 3-year-old boy with myelodysplastic syndrome developed thumb necrosis due to Aspergillus infection.
- Case 2: An 18-year-old female with acute megakaryoblastic leukemia experienced an Aspergillus skin infection on the wrist, with vascular complications.
Findings:
- Angiography in Case 2 revealed vascular irregularities, indicating vessel involvement.
- Intraarterial infusion of urokinase and amphotericin B improved symptoms in Case 2.
- The study highlights the potential for Aspergillus to cause severe extremity infections in leukemia patients.
Implications:
- The combination of urokinase and antifungal therapy should be considered for intractable Aspergillus infections of the extremities.
- Early recognition and aggressive treatment are crucial for managing invasive aspergillosis in immunocompromised patients.
- This approach may improve outcomes for limb-threatening fungal infections.